Saturday, March 08, 2008

Progress on parity

According to a press release from the Eating Disorders Coalition, eating disorders "were front and center" in the debate that ended with the House passing its own version of a mental health parity bill, 268 to 148. The House version is much better than the Senate version passed last year, but it's unlikely to be the one passed in the end.

Still, the fact that we're even talking about having a mental health parity bill in this country just blows my mind. It's about goddamn time.

I love this quote from EDC executive director Marc Lerro: “We made our points so often that members of Congress started making our points for us. In committee meetings, Republicans and Democrats alike described how parity could affect people with eating disorders.”

Now that's activism at work.

Another good quote comes from David Wellstone, son of the late Senator Paul Wellstone of Minnesota. He felt the Senate bill didn't go far enough and refused to let it be named after his father, saying, “My dad always believed that you can’t leave people out." The Senate version would not protect people with eating disorders to the same degree as the House version.

3 comments:

It is a start...but even the House version of the bill--which is more comprehensive than the Senate version--is full of holes. It doesn't mandate that insurers PROVIDE mental health coverage--only that they have parity if they do. It doesn't apply to insurance provided by small businesses or to providers of insurance policies for individuals. There's nothing in there that prevents insurers from simply reducing physical health benefits as a way to achieve reimbursement equity. I suppose it's good that it's even being discussed and moving forward, but there's still a long, long, LONG way to go. (Then again, maybe the problem lies not with how this bill gets mental health covered, but with the ridiculous nature of our insurance system.)

A great quote, from the Bush administration on this bill, which they opposed: “[the bill] would effectively mandate coverage of a broad range of diseases.”

Certainly it's the point, but the problem is that it effectively gives control of those diseases to the insurance providers. The insurance can tell you that you only have so much coverage (so if you were counting on it, it may only be there a fraction of the time you need); That you can only get it from certain providers (which may end up losing whole treatment methods), and they can find more of those lovely HIPPA holes to throw your file it where you don't get to control the information anymore. There is a whole range of people who don't trust corporate entities to have that kind of power even with (in some cases ESPECIALLY with) government supervision.

Besides the trust issue, health insurance costs have been on the rise for a long time. Mandating any kind of coverage is only going to raise those costs even more, simply because it can. I guarantee you that, even with the most compassionate corporation you can imagine, some of that cost is going to have to be absorbed by individuals. Even the companies that do their best for their employees are going to find themselves with less money to create more jobs.

None of which means I disagree with the intent of the bill; I think its marvelous that someone is trying to get it, that Congress is trying to wrap their mind about things they don't really understand and coming to some logical conclusions. I'm just wary about how it will end up affecting people. Nothing works out entirely positively, there are always trade-offs. What are the trade-offs in this?

And that raises an excellent question: How do you bring about change in a situation like this? I agree with both of the commenters here. This bill both is a step in the right direction and is bound to have consequences we can't foresee--negative consequences for ordinary folks. Yet what's a better solution?

What I know is that right now, the way mental illness is treated (or not) is what my grandmother would have called a shanda--a shameful thing. We have to do better than this. A step forward, I have to believe, is a positive thing even if it's not the ultimate answer.

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About Me

I teach magazine journalism at the S.I. Newhouse School of Public Communications, and write for many magazines and newspapers. My newest book is BRAVE GIRL EATING: A FAMILY'S STRUGGLE WITH ANOREXIA, which will be published by William Morrow this fall. I believe in the power of words to change the world (or at least the interior lives of individuals).